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Urban Overdose Hotspots: A 12-Month Prospective Study in Dublin Ambulance Services
Date Issued
2014-07
Date Available
2014-08-22T15:12:27Z
Abstract
Background: Opioid overdose is the primary cause of death among drug users globally. Personal and social determinants of overdose have been studied before, but the environmental factors lacked research attention. Area deprivation or presence of addiction clinics may contribute to overdose. Objectives: To examine the baseline incidence of all new opioid overdoses in an ambulance service, and their relationship with urban deprivation and presence of addiction services. Methods: A prospective chart review of pre-hospital advanced life support patients was performed on confirmed opioid overdose calls. Demographic, geographic, and clinical information, i.e. presentation, treatment, outcomes, was collected for each call. The Census data were used to calculate deprivation. Geographical information software mapped the urban deprivation and addiction services against the overdose locations. Results: There were 469 overdoses, 13 of which were fatal; most were male (80%), of a young age (32 years), with a high rate of repeated overdoses (26%), and common poly-drug use (9.6%). Majority occurred in daytime (275), on the streets (212). Overdoses were more likely in more affluent areas (r = .15, P < .05), and in a 1000 m radius of addiction services. Residential overdoses were in more deprived areas than street overdoses (mean difference 7.8, t(170) = 3.99, P < .001). Street overdoses were more common in the city centre than suburbs (χ2(1) = 33.04, P < 0.001). Conclusions:
the identified clusters of increased incidence – urban overdose hotspots - suggest a link between environment characteristics and overdoses. This highlights a need to establish overdose education and naloxone distribution in the overdose hotspots.
Other Sponsorship
MERIT
Type of Material
Journal Article
Publisher
Elsevier
Journal
The American Journal of Emergency Medicine
Volume
32
Issue
10
Start Page
1168
End Page
1173
Copyright (Published Version)
2014 Elsevier
Language
English
Status of Item
Not peer reviewed
This item is made available under a Creative Commons License
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